Pregnancy Outcomes in Females with Stage 1 Hypertension and Elevated Blood Pressure Undergoing In Vitro Fertilization and Embryo Transfer

Abstract

Objective: To determine whether stage 1 hypertension and elevated blood pressure (BP), as defined by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, prior to pregnancy contributes to adverse pregnancy outcomes in females who conceived by in vitro fertilization and embryo transfer (IVF–ET). Methods: This retrospective cohort study involved 2239 females who conceived by IVF–ET and delivered live neonates. BPs recorded before IVF–ET were collected. Elevated BP was defined as at least two systolic BPs of 120 to 129 mmHg. Stage 1 hypertension was defined as at least two systolic BPs of 130 to 139 mmHg or diastolic BPs of 80 to 89 mmHg. Results: Among the females included in this study, 18.5% (415/2239) had elevated BP and 10.0% (223/2239) had stage 1 hypertension. Multiple logistic regression analysis showed that females with stage 1 hypertension had higher risks of hypertensive disorders in pregnancy (HDP) [adjusted odds ratio (aOR) 1.65; 95% confidence interval (CI) 1.16–2.35] and preeclampsia (aOR 1.52; 95% CI 1.02–2.26) than normotensive females. However, the risks of HDP (aOR 0.88; 95% CI 0.64–1.21) and preeclampsia (aOR 0.83; 95% CI, 0.57–1.20) in females with elevated BP were not significantly different from those in normotensive females. The females were then categorized into five groups by systolic and diastolic BP; females with systolic BP of 130 to 139 mmHg or diastolic BP of 85 to 89 mmHg had significantly increased risks of HDP and preeclampsia. Conclusion: Stage 1 hypertension before IVF–ET was an independent risk factor for HDP and preeclampsia.